| NPI | 1083221519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN1293242) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN156097) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |